NPI | 1760496350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 179637) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA60701) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2021-05-27 |